SCHEDULE V                                                                                                         OMB No. 1545-0123
(Form 1120-F)                   List of Vessels or Aircraft, Operators, and Owners
                                                       ▶ 
Department of the Treasury                               Attach to Form 1120-F.
Internal Revenue Service          ▶  Go to www.irs.gov/Form1120F for instructions and the latest information.      2021
Name of corporation                                                                                Employer identification number

Provide the information requested on lines 1 through 9 for each vessel or aircraft with respect to which the corporation is subject to a 
4% rate of tax under section 887. If you check “Yes” on line 3 or line 4 for a vessel or aircraft chartered in or chartered out, see 
instructions to determine whether you must attach a statement to Schedule V with additional information.

                                                                 A               B                            C      D

1  Name of vessel or type of aircraft  .     . . .

2  Vessel or aircraft ID number .      .   . . . .

3  Was the vessel or aircraft chartered in?  .   .       Yes       No          Yes   No          Yes            No Yes               No

4  Was the vessel or aircraft chartered out?     .       Yes       No          Yes   No          Yes            No Yes               No

5  Name of registered owner  .         .   . . . .

6  EIN or SSN of registered owner          . . . .

7  Name of operator  .          . .  . .   . . . .

8  EIN or SSN of operator  .         . .   . . . .
9  U.S. source gross transportation income. See 
   instructions  for  details  regarding  a  statement 
   that  must  be  attached  to  Schedule  V 
   describing the method used to determine your 
   U.S. source gross transportation income       .

10 Total U.S. source gross transportation income.        Add the amounts on line 9, columns 
   A through D (and the amounts on line 9 of any attached continuation statements) .   .         10

11 Amount of line 10 that is exempt by treaty (attach Form 8833).    .    . .  . . . . .         11

12 Subtract line 11 from line 10. Enter the result here and on Form 1120-F, Section I, line
   9, column (b) .          . . . .  . .   . . . . .   . . .     . . .    . .  . . . . .         12
For Paperwork Reduction Act Notice, see the Instructions for Form 1120-F.        Cat. No. 50821R                Schedule V (Form 1120-F) 2021